What is included in the long-term monitoring of pediatric type 1 diabetes mellitus (DM)?

Updated: Jul 03, 2019
  • Author: William H Lamb, MD, MBBS, FRCP(Edin), FRCP, FRCPCH; Chief Editor: Sasigarn A Bowden, MD  more...
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Answer

Regular outpatient review with a specialized diabetes team improves short- and long-term outcomes. [55] Most teams have a nurse specialist or educator, a dietitian, and a pediatrician with training in diabetes care. Other members can include a psychologist, a social worker, and an exercise specialist. Involvement with the team is intense over the first few weeks after diagnosis while family members learn about diabetes management. [56, 57]

Conduct a structured examination and review at least once annually to examine the patient for possible complications. Examination and review should include the following:

  • Growth assessment

  • Injection site examination

  • Examination of the hands, feet, and peripheral pulses for signs of limited joint mobility, peripheral neuropathy, and vascular disease

  • Evaluation for signs of associated autoimmune disease

  • Blood pressure

In individuals aged 11 years or older, further examination should include the following:

  • Retinoscopy or other retinal screening, such as photography

  • Urine examination for microalbuminuria


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